Fungal Acne vs Closed Comedones: What to know
When it comes to fungal acne vs closed comedones, it is critical to understand that the two are very different skin conditions.
While they may both cause similar symptoms, such as redness, inflammation, and bumps on the skin, they require different treatments in order to be effectively cleared.
In this article, we will discuss the differences between fungal acne and closed comedones, how to identify each and the best methods for treating them.
What are closed comedones?
Closed comedones, also known as whiteheads, are small bumps that form when dead skin cells and sebum become trapped in your pores.
Unlike blackheads, which have a wider opening at the surface of the skin, closed comedones are sealed beneath the surface of the skin, making them more difficult to treat.
Closed comedones typically appear on the forehead, nose, and chin – areas of the face that are more prone to oil buildup. Comedones are also often classified as a form of non-inflammatory acne [1].
Causes and symptoms of comedonal acne
Comedonal acne is caused by excess oil production and the build-up of dead skin cells in the pores.
This can be the result of hormone imbalances, certain medications, genetic factors, or even cosmetics that clog the pores.
When the pore is blocked, oxygen can’t reach the trapped sebum and bacteria, causing it to turn white. This can cause the pores to become clogged and enlarged, leading to the formation of a whitehead.
Unlike inflammatory acne, non-inflammatory acne (open and closed comedones) develops much closer to the surface of the skin and is not as painful as deeper formations like nodules and cysts.
What do closed comedones look like?
Closed comedones are usually small, raised, and flesh-colored, but they can become inflamed and red if they are aggravated.
See Fig. 1 Below for an Illustration
What is fungal acne?
We know it can be confusing trying to understand all the jargon and technical terms when it comes to fungal acne. To make things simple, fungal acne is a type of acne caused by a yeast infection.
The term fungal acne is the most widely used name for this skin disease. However, the scientific name is Malassezia folliculitis or Pityrosporum folliculitis.
Fungal acne is most common on the back, chest, and arms, but it can also occur on the face and other parts of the body [2].
What causes fungal acne and what are the main symptoms associated with this skin conditions?
Fungal acne is caused by an overgrowth of yeast on the skin. This overgrowth of yeast can lead to the appearance of tiny bumps, as well as redness, itching, and flaking of the skin.
Fungal acne is often mistaken for other skin conditions, such as acne, eczema, or keratosis pilaris.
This can make it very tricky to treat, not due to a lack of treatment options, but incorrect assumptions about what is causing the problem.
We’ve gathered some of the most effective fungal acne treatments in the treatment section to help you get rid of this problem fast.
What will fungal acne look like on the skin’s surface?
Fungal acne typically shows up as tiny bumps on the skin due to clogged pores caused by yeast.
These pesky pimples may be itchy or painful, and they may also produce pus. In some cases, fungal acne can also lead to hair loss [3].
See Fig. 2 Below for an Illustration.
Fungal acne vs closed comedones: important distinguishing characteristics to be aware of
Although fungal acne and closed comedones may have some similarities, there are key distinctions between the two that are important to be aware of in order to properly diagnose and treat each condition.
The primary difference between fungal acne and closed comedones is the presence of an overgrowth of yeast on the skin.
This overgrowth of yeast can cause a number of problems, including the formation of clogged pores and pimples.
Fungal acne is also more likely to cause itching and burning sensations.
Closed comedones, on the other hand, are simply plugged hair follicles that have become clogged with sebum and dead skin cells.
While they can also be unsightly, they are not usually accompanied by the same symptoms as fungal acne.
The role of the hair follicles in the formation of all forms of acne
The hair follicles are an important part of the skin’s structure. They are tiny holes in the skin that allow hair to grow through.
The follicle also contains a sebaceous gland, which produces sebum. Sebum is an oily substance that helps keep the skin moisturized.
Both comedonal and fungal acne occurs when the hair follicles become clogged with dead skin cells etc.
The clogging of the follicle can be caused by a number of things, including hormone imbalances, certain medications, cosmetics that clog the pores, and an overgrowth of yeast.
When the follicle becomes clogged, it provides the perfect environment for acne-causing fungi and bacteria to grow.
This can lead to the formation of pimples, whiteheads, blackheads, and other types of acne.
Pro-Tip
No matter what form of acne you are struggling with, keeping your pores clear is essential for healthy skin.
Jump to our list of the most popular products available over the counter to treat comedonal and fungal acne, while keeping your pores clean and clear.
In a hurry? Jump straight to our recommended products for treating acne
Some general Dos and Don’ts of caring for acne prone skin
DO
- Cleanse your face twice daily with a mild, oil-free, non-irritating cleanser
- Shower regularly, especially after a sweat session
- Do keep your skin properly hydrated with gentle toner as dehydration can worsen acne
- Moisturize regularly
- Use oil-free cosmetics and sunscreens
- Shampoo regularly if you have oily hair
- Keep your hair clean and off your face
- Do eat a healthy diet and drink plenty of water to keep the body hydrated from the inside out
- Do wear sunscreen to protect your skin from the harmful rays of the sun
- Do see a dermatologist if you are struggling to get your acne under control, or if you’re dealing with severe acne
Pro-Tip
A very vital and often overlooked component of acneic skin is a dysfunctional skin barrier. When this barrier is damaged, it can lead to dryness, redness, and inflammation [4].
Also, studies have shown us that the sebum of acne-prone individuals has lower amounts of linoleic acid, which is essential for the health of the skin [5 , 6].
If we repair any defect in the skin’s barrier function with ceramide-based treatments and linoleic acid deficiencies with linoleic acid rich remedies, we can improve our skin’s health.
To accomplish this, try incorporating the products listed below into your daily regimen.
Affiliate Disclosure: We include products that we believe will be beneficial to our readers. If you make a purchase using the links on this page, we may receive a commission.
Ceramides enhancing products:
DRMTLGY’s – Twice a day Needle-less Serum (TOP PICK)
-OR-
CeraVe’s – fragrance-free, barrier-strengthening GENTLE MOISTURIZER
Will be particularly beneficial to individuals with comedonal acne attempting to restore the moisture barrier.
Here are some linoleic acid-rich products to consider, which is an important fatty acid for resolving comedonal acne-prone skin.
Preservative-free Moisturizer by Mother Dirt -OR- Advanced Replenishing Toner by Paula’s Choice can help replenish the low levels of linoleic acid on the surface of the skin.
NB: Keep in mind that these 4 products are only suggested for comedonal acne ONLY since they may contribute to the proliferation of fungal acne.
DONT’S
- Don’t use cleansers with harsh ingredients and don’t scrub or over-cleanse as this can strip your skin of its natural oils and lead to dryness, which can actually trigger more breakouts
- Don’t pick or squeeze your pimples as this can cause scarring
- Don’t use tanning beds or sunlamps
- Don’t use too much hair product
- Don’t smoke as it can damage your skin
- Don’t rest your chin or cheeks on your hands
It is also important to:
- Avoid greasy cosmetics and sunscreens
- Avoid touching your face throughout the day
- Avoid stress. Stress can wreak havoc on your skin, so find ways to relax and unwind
The Ultimate Anti-Fungal Acne Protocol
Thinking about fungal acne can be overwhelming. There are a lot of different products and treatments out there, and it can be hard to know where to start. But don’t worry! We’re here to help.
Let’s start at the source
If you have “comedonal fungal acne”, regular acne treatments such as benzoyl peroxide will not help, because this type of acne is driven by yeast overgrowth and not bacteria.
In fact, many conventional acne treatments have a “dehydrating effect” on the skin and can cause irritation, which can result in new acne breakouts.
Instead, try a dandruff shampoo or oral antifungal medication which are pretty effective therapies used to treat fungal acne.
Internal Supplements
Probiotics are live microorganisms (usually bacteria) similar to the ones already present in our bodies.
When taken orally, they can help restore the balance of microorganisms in the gut, which may help reduce inflammation and the severity of acne.
One of our favorite and most effective probiotics is Hyperbiotics, which is available in both male and female forms.
Are your existing products making your fungal acne worst?
Malassezia is a lipid-dependent microorganism, which means it can feed on the oils and fats in our skincare products.
Therefore, you should avoid using beauty or personal care products containing certain types of oils, esters, polysorbates, and fatty acid ingredients, as these may cause fungal acne outbreaks.
The list of substances that can exacerbate fungal acne is rather lengthy. For this reason, we have created our fungal acne ingredient checker to help you sift through ingredient lists and alert you to the ones that could be problematic.
Treating fungal acne – The best fungal acne skincare routine
STEPS 1&2
Start with a clean slate, The most important step in an OTC fungal acne routine
The first step in any good skincare routine is to make sure your skin is clean.
This is especially true for over-the-counter fungal acne medications, as the solution is usually a cleansing product as well.
Nizoral is without a doubt the best non-prescription fungal acne medication on the market. That’s because it contains 1% Ketoconazole, which is an extremely potent fungal acne-killing component.
[Get Nizoral for fungal acne on Amazon]
To use the product, apply it to the affected regions as directed on the package and keep within the recommended usage time.
On the days that you are not using Nizoral as a fungal acne face wash, you will need a gentle cleanser that won’t strip your skin of its natural oils.
For gently cleansing the skin one of our go-to products is the Extreme Cleansing Lotion by Avene.
If you have sensitive skin and can’t use Nizoral. A gentler face wash for fungal acne worth trying is the Happy Cappy Medicated Wash.
This is a face, hair, and body wash that was designed specifically for fungal infections.
STEP 3 – Keep your skin toned and properly hydrated
One of the drawbacks of using Nizoral is that it may be harsh on the skin since it was not designed for facial use.
So, in order to avoid any dryness that may result from usage, an ultra-hydrating toner is a must-have.
This helps not only to deeply hydrate the skin but also restores the skin’s pH balance, which is a crucial component in the treatment of any type of acne [7].
For this task look no further than ISNTREE – Hydrating Plus Toner
This toner is alcohol-free and massively hydrating, plus it’s loaded with anti-inflammatory ingredients like chamomile, centella asiatica, green tea, licorice root, and panthenol.
STEP4 – Seal in hydration with a fungal acne safe moisturizer
The next step in the routine is to seal in all that moisture with a good-quality moisturizer.
For fungal acne, it’s important to find a moisturizer that doesn’t contain any fungal-feeding ingredients.
A very safe and effective option is Malezia’s 5% Urea moisturizer
[Grab Malezia 5% Urea Moisturizer NOW]
Another crowd-pleaser is is Avene’s minimal ingredients Tolerance Extreme
[Shop NOW – Avene Tolerance Extreme Emulsion]
A lot of people with fungal acne also find that their skin is on the drier side. If this sounds like you, consider using a hydrating serum before your moisturizer.
Facetheory’s – Porebright Serum N10 is our fave.
This lightweight serum contains 10 percent Niacinamide, Hyaluronic Acid, and Salicylic acid, which tackles dehydration, hyperpigmentation, large pore size, and redness. It also decreases oil production, unclogs pores, and gently exfoliates the skin. This product is awesome.
[Shop NOW- Porebright Serum N10 | facetheory]
Another fungal acne safe serum that hits all the key points we look for is Almond’s Clear – Level 1 Serum
[Grab the -Level1 Serum Now | Almond Clear]
Hyaluronic Moisture Boost Serum by Trader Joe’s. Is also another solid fungal acne safe option.
STEP5 – Protect your skin with sunscreen
The last step in any fungal acne skincare routine is to apply sunscreen.
This is not important strictly for fungal acne reasons but also for general skin health.
When it comes to sunscreen, we recommend looking for a physical sunscreen with zinc oxide as the active ingredient.
Choose a sunscreen with an SPF of at least 30 and apply it generously to all exposed areas of the skin. Reapply every two hours or as needed.
A good option is DRMTLGY’s – Broad Spectrum SPF 45
This sunscreen is dermatologist recommended and contains 12% zinc oxide to provide sturdy protection against the sun’s harmful rays.
It also contains sodium hyaluronate and niacinamide to help hydrate, brighten and calm the skin.
STEP6 – (Exfoliation)
If you’ve cleared up your skin and it’s free of fungal acne, consider using a weekly exfoliation treatment containing salicylic acid or the “more gentle urea” or sulfur-based product to speed up cell turnover and help keep your pores clear.
When incorporating this step with the above regimen, it would be used on days that you are not applying any active antifungal acne medications as a preventive measure.
Now that you know the basics of a fungal acne skincare routine, you’re ready to start treating your fungal acne!
Just remember to be patient – it can take time to see results. But we promise it’s worth it.
The Ultimate Anti-Closed Comedonal Acne Protocol
If you are struggling with whiteheads, also known as “closed comedones,” you are not alone.
Here are a few tips to help you get rid of those pesky blemishes for good.
As we already know closed comedones are formed when dead skin cells and sebum (oil) become trapped in your pores.
This can happen when your skin is not properly cleansed, when you use products that are too heavy or occlusive, or when you have a buildup of dead skin cells.
But, what can we do internally to help with non-inflammatory acne?
Taking a solid probiotic supplement is one of the most effective things that anyone with acne can do to start clearing their skin from the inside out.
Probiotics are live microorganisms that are similar to the good bacteria that naturally reside in your gut.
When taken orally, probiotics can help replenish the good bacteria in your gut, which can promote a healthy digestive system and overall good health.
Recent research has shown that probiotics may also be effective in treating acne [8].
A small study published in the Journal of Dermatological Therapy found that probiotic supplements helped reduce acne symptoms in people with mild to moderate acne [9].
When it comes to comedonal acne, we prefer the following probiotics.
[Hyperbiotics Pro-15 Advanced Strength Probiotic – Amazon]
This probiotic supplement helps acne by restoring balance to the gut microbiome.
This product contains 15 different strains of live probiotic bacteria, including Lactobacillus acidophilus and Bifidobacterium, which have been shown to be effective against acne [10].
Hyperbiotics Pro-15 Advanced Strength Probiotic is also free from artificial colors, flavors, and sweeteners, and is vegan and gluten-free.
[Shop Now – Hyperbiotics Pro-15 Advanced Strength Probiotic – Amazon]
A simple yet effective routine for treating comedonal acne
STEP -1 Cleansing comedonal acne skin
Acne-prone skin is best cleansed with a gentle, non-abrasive, non-comedogenic, sulfate-free cleanser or face wash that does not strip the skin of its natural oils.
If you have sensitive, normal, dry, or combination skin we recommend none other than this ultra-gentle, low-pH, soap-free Cleanser by Avene.
[Shop Now – Avene Gentle Cleanser – Amazon]
For those with oily skin, look no further than CeraVe face wash. It is a benzoyl peroxide face wash, which is an exceptional option for cleansing oily, acne-prone skin.
[Shop Now – CeraVe face wash for acne – Amazon]
If your comedonal acne is more on the severe end of the spectrum one of the most powerful ance cleansers available is Humane’s – Maximum Strength 10% Benzoyl Peroxide Acne Wash.
STEP2 – Keep your skin toned and hydrated
A toner can be beneficial for acne-prone skin as it can help to remove excess oil and impurities, and can also help to balance the skin’s pH levels.
When choosing a toner for acne-prone skin, it is important to choose one that is alcohol-free and non-comedogenic, as these will be the least likely to aggravate the skin.
Toners can also help to intensely hydrate the skin and prepare it for the acne treatments that follow, allowing the medication to go deeper into the skin where it’s most effective.
Our favorite hydrating treatment toner for sensitive acne-prone skin is Cosrx AHA/BHA Clarifying Treatment Toner.
[Shop Now- Cosrx AHA/BHA Clarifying Tone – Amazon]
For normal to dry skin, we really like Etude’s SoonJung CICA Relief Toner.
[Shop Now – Etude’s SoonJung CICA Relief Toner – Amazon]
And for oily acne-prone skin, our toner of choice is SOME BY MI – 30 Days Miracle Toner.
STEP3 – Treatments that work for comedonal acne
There are a few different types of acne treatments that work well for people with comedonal acne.
These include retinoids, benzoyl peroxide, and salicylic acid. There are also natural remedies that can be effective, such as honey and Tea tree oil.
One of our favorite benzoyl peroxide-based products for comedonal acne is
La Roche-Posay – 5.5% Effaclar Duo Dual Action Acne Spot Treatment Cream
[Shop Now – Effaclar Duo Dual Action Acne Spot Treatment Cream – Amazon]
Another cult favorite is Malezia Acne Treatment Gel simple yet very effective.
[Shop Now – Malezia – Acne Treatment Gel (2.5% Micronized Benzoyl Peroxide)]
Our favorite retinoid-based product for comedonal acne is la La Roche-Posay’s – Prescription-strength Effaclar Adapalene Gel 0.1% Acne Treatment
[Shop Now – Adapalene Gel 0.1% Acne Treatment- Amazon]
One of the most effective salicylic acid-based comedonal acne treatments is Humane’s 2% BHA Salicylic Acid Toner
[Shop Now Humane Toner (2% BHA) – Amazon]
If your skin can tolerate it, step up to the Advanced Pore-Refining Treatment 4% BHA (beta hydroxy acid) acne treatment for faster results
[Shop Now – Paula’s Choice RESIST Advanced Pore-Refining Treatment – Amazon]
For a more natural approach, you really can go wrong with this potent Honey-Based – Manuka Relief Cream from Clearbody Organics or the powerful Tea Trea Oil-based Acne Treatment Serum from BREYLEE.
NB: No matter how good they are or how tempting they may seem, you shouldn’t use too many treatments in one day. Instead, you should try to spread out your efforts, because over-treating your skin to get rid of acne can backfire resulting in more acne.
STEP4 – Moisturizers that work wonders for comedonal acne
Acne moisturizers are designed to hydrate and nourish acne-prone skin.
They can help to soothe irritation and inflammation, as well as reduce the appearance of blemishes.
Look for products that contain ingredients like hyaluronic acid, urea, niacinamide, and ceramides, which are all beneficial for acne-prone skin.
Avoid products that contain pore-clogging ingredients like mineral oil and petrolatum, as these can worsen breakouts.
Moisturizers for Comedonal Acne
The ever-popular cult fave Avene Emulsion is a top-performing moisturizer for skin that is prone to comedonal acne – Tolerance Extreme Emulsion is ideal for sensitive, dry, or even eczema-prone skin.
[Shop NOW – Avene Tolerance Extreme Emulsion – Amazon]
Any list of acne moisturizers cannot be complete without Malezia 5% Urea.
Malezia’s 5% Urea Moisturizer combines intense hydration and gentle exfoliation, to help your skin stay healthy and supple.
[Shop Now – Malezia 5% Urea Moisturizer NOW]
For oily skin, we really really like Almond Clear’s – 2-In-1 Hydrating Gel.
Another note-worthy moisturizer for oily acne-prone skin is facetheory’s – Supergel Oil-free Moisturiser.
STEP 5 – The best sunscreens for comedonal acne
Sunscreen is an important part of any skincare routine, but it is especially important for those who are prone to breakouts.
comedonal acne-prone skin is more susceptible to inflammation and sun damage, so it is essential to use sunscreen that is specifically formulated for acne-prone skin.
These sunscreens will be non-comedogenic, meaning they won’t clog pores, and they will often contain ingredients that help to control sebum production.
For this, we look no further than DRMTLGY’s Anti-Aging Lightweight Sunscreen, which is a broad-spectrum sunscreen with an SPF of 45.
STEP 6 – Avoid anything potentially pore-clogging for comedonal acne-prone skin
Avoid skin-irritating and other pore-clogging ingredients that can lead to acne. This means avoiding ingredients like:
- Coconut oil
- Isopropyl palmitate
- Mineral oil
- Isopropyl myristate
- Paraffin
- Algae extract
- Lanolin
Again our ingredient checker can come in very handy for assessing the ingredient in your current product so you can know if they are safe to continue using or not.
Comedonal acne skincare routine recap
With a little bit of effort, you can get rid of closed comedones and keep them from coming back.
Just be sure to cleanse your skin thoroughly, use an exfoliant to prevent dead skin cell buildup, and use a light moisturizer to help control oil production.
And don’t forget to wear sunscreen every day to protect your skin from the sun’s damaging rays.
NB: If you have the time, patience, and resources to experiment with different comedonal acne treatment moisturizers, go for it.
If you want results without the fluff, we suggest testing one product from each category we suggested, since we believe they will help you achieve your goal.
What to do if nothing is working or your acne seems to be getting worse?
If you’re struggling to get rid of your fungal acne, or if you have closed comedones that are not responding to home treatment, it may be time to see a dermatologist.
A dermatologist can prescribe medication that will help clear up your fungal acne for good with oral antifungal medication or other topical antifungal creams.
They can also prescribe oral or topical antibiotics, retinoids, or other medications that will help clear up your comedonal acne.
In the meantime, be sure to follow the tips outlined in this article to help manage your comedonal acne or fungal acne and prevent it from getting worse.
Summary
Closed comedones vs fungal acne can sometimes be difficult to tell apart.
However, there are key differentiating factors such as itching, burning, or a stinging sensation associated with fungal acne vs no itching, burning, or stinging sensation associated with closed comedones.
if you are looking for an effective way to treat closed comedones, it is important to first understand what causes them. Dead skin cells, excess oil, and bacteria can all contribute to the formation of these bumps.
Fungal acne, on the other hand, is a pimple-like rash caused by an overgrowth of yeast on the skin. This can lead to symptoms like redness, itchiness, and flaking skin.
Once you’ve figured out what’s causing your acne, you can use the appropriate treatment to get rid of the bumps.
The main takeaway: Fungal acne is caused by an excess of yeast on the skin, while comedonal acne ( bacterial acne) is caused by bacteria, dead skin, and sebum.
If none of the outlined methods works to get your acne under control then it’s time to visit a board-certified dermatologist for a proper diagnosis so that they can prescribe the right treatment.
- “Management of Comedonal Acne Vulgaris with Fixed-Combination Topical Therapy – PubMed.” PubMed, 1 Apr. 2018, pubmed.ncbi.nlm.nih.gov/29380941.
- CRubenstein, Richard M., and Sarah A. Malerich. “Malassezia (Pityrosporum) Folliculitis – PMC.” PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC3970831. Accessed 13 Sept. 2022.
- Trüeb, Ralph M., et al. “Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress – PMC.” PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC6369642. Accessed 13 Sept. 2022.
- Thiboutot, Diane, and James Q. Del Rosso. “Acne Vulgaris and the Epidermal Barrier: Is Acne Vulgaris Associated with Inherent Epidermal Abnormalities That Cause Impairment of Barrier Functions? Do Any Topical Acne Therapies Alter the Structural and/or Functional Integrity of the Epidermal Barrier?” PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC3579484. Accessed 13 Sept. 2022.
- Lin, Tzu-Kai, et al. “Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils – PMC.” PubMed Central (PMC), 27 Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5796020.
- Kim, Ji Hyun, et al. “A Randomized, Placebo-Controlled Trial of Gamma Linolenic Acid as an Add-on Therapy to Minocycline for the Treatment of Rosacea – PMC.” PubMed Central (PMC), 11 Nov. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7875229.
- “pH and Acne – PubMed.” PubMed, 1 Jan. 2018, pubmed.ncbi.nlm.nih.gov/30130780.
- Kober, Mary-Margaret, and Whitney P. Bowe. “The Effect of Probiotics on Immune Regulation, Acne, and Photoaging.” PubMed Central (PMC), 6 Apr. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC5418745/#:~:text=By%20decreasing%20the%20counts%20of,effects%20resulting%20from%20acne%20therapies.
- “The Potential of Probiotics for Treating Acne Vulgaris: A Review of Literature on Acne and Microbiota – PubMed.” PubMed, 1 May 2020, pubmed.ncbi.nlm.nih.gov/32266790.
- Chilicka, Karolina, et al. “Microbiome and Probiotics in Acne Vulgaris—A Narrative Review – PMC.” PubMed Central (PMC), 15 Mar. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC8953587.
